Brief Answer:
both problems can be treated

Detailed Answer:
Hello,

Thanks for writing to us.

In patients with hypertension sexual problems are common.

First of all Premature Ejaculation (PME) defined when male partner ejaculates early before the female partner reaches to orgasm. There is no absolute time by which we can diagnose PME. It is relative term and female partner is the best judge.

Treatment:

Medicines:
Clomipramine and paroxetine are choice of medicines which are used as antidepressants (For depression dose is higher).
I prefer clomipramine for PME. No significant side effects with these medicines. Initially say for 20-30 days daily after dinner and later on just on the day when you do the sex.
Paroxetine is more potent but it may cause side effects like headache, gastric discomfort, giddiness and sedation. In patients with blood pressure it should be used in consultation with physician/cardiologist.

One molecule called depoxetine has been used specifically for PME and should be taken before 2 hours of sex when required.
These medicines are prescription medicines and you need to consult doctor/psychiatrist/sexologist for prescription.

In your case if I were your treating doctor I will prefer clomipramine.

Low libido can be due to hypertension, stress or low testosterone.
You can go for serum testosterone level.

You need to keep your blood pressure and cholesterol in control.

Treatment:

You can use medicine cum vitamin supplement containing pyridoxal-5-phosphate, mecobalamin and l-methylfolate (trade name tetrafol plus)is very helpful in my patients. It has shown improvement in 50-60% patients of mine with blood pressure. You may get this medicine over the counter as it is vitamin product.

As you are likely form XXXXXXX I would like to also mention ayurvedic medicine option. Tentex forte is the medicine which is used for sex related problem. No side effects have been reported.

If I were your treating doctor I suggest one tablet of tetrafol plus after meal twice daily for two months and one tablet tentex forte daily at night with a cup of milk for 4 weeks.

There are some natural lifestyle measures which help to improve blood flow to penis and overall sexual performance.

- The most important factor is healthy heart. Blood is pumped in to body by heart. So regular exercise and avoidance of fatty fast food are important measures to prevent heart disease. Regular walking, swimming or running overall improves blood flow to whole body circulation including penis and keep the mind fresh.

- Good healthy food is also an important aspect. Bananas, Garlic, dry fruits(they contains vitamins), eggs, cow milk, cow butter are good food which may help in erectile dysfunction.

- Avoid smoking and alcohol. Low amount of alcohol can help in increasing blood flow but more amount can cause opposite effects. So better to avoid the same.


Hope I have answered your query, I will be happy to help further.

Regards,

Dr.Chintan Solanki.

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